CRC Surveillance — SCE Medical Oncology MCQ

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EasyGI CancersCRC SurveillanceSCE Medical Oncology

A 60-year-old man with colorectal cancer presents with rising CEA (from 5 to 35 ng/mL) during post-surgical surveillance. CT chest/abdomen/pelvis is normal. What is the next investigation?

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Correct answer: C — PET-CT

When CEA rises during CRC surveillance but conventional imaging (CT) is negative, PET-CT is recommended to detect occult recurrence. PET-CT has superior sensitivity for detecting small-volume metastatic disease, peritoneal deposits and local recurrence not visible on CT. A positive PET may guide biopsy and identify potentially resectable recurrence. NICE NG151 recommends PET-CT when there is clinical suspicion of recurrence not confirmed on CT.

Reference: NICE NG151 Colorectal cancer; ESMO 2024 Early Colorectal Cancer Guidelines